As of January, 2007, all U.S. chiropractic colleges must teach wellness measures and health promoting efforts including smoking cessation.

Recently, a publication is Chiropractic and Manual Therapies entitled, Systems change to improve tobacco use identification and referral in the chiropractic setting: a pilot study by Kelly Buettner-Schmidt, et al. tested an intervention to assist chiropractors to implement sustainable changes for tobacco use based on U.S. Public Health Service guidelines. Chiropractors were taught the Ask, Advise, Refer (AAR) approach, provided with ongoing guidance, and followed for six months to assess systems change. The study was conducted from March 2016 to July 2017. Five clinics succeeded in having individual months of ≥50% of tobacco users being advised, and three clinics achieved the formal definition of systems change. Four clinics had individual months of ≥50% of tobacco users being referred. The patient quit rate was 13.3% (n= 15) for the 30-day follow-up and 16.7% (n= 6) for the three-month follow-up. It has previously been reported that 6% of patients quit because their doctor advised them to . This makes this study's stats even more impressive.

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Also, similar to the tobacco industry, a targeted approach to a younger demographic may be prudent. Maryville University has a great resource page for information regarding the unique demographics of college students who smoke. Certainly, levels of stress and past exposure are important features, yet the “social setting” is often expressed by college students as significant.